Provider Demographics
NPI:1245490978
Name:SPARKS, SARAH NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:SPARKS
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2427
Mailing Address - Country:US
Mailing Address - Phone:804-794-9789
Mailing Address - Fax:804-794-9762
Practice Address - Street 1:14420 SOMMERVILLE CT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6835
Practice Address - Country:US
Practice Address - Phone:804-897-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice